Mr. L., a 55-year-old bartender in a large metropolitan area, has been a heavy smoker for 40 years. He was diagnosed as having COPD 7 years ago. Mr. L. lives in the city and takes the city bus to work, although he still has to walk about three blocks to the bar where he works. He has found it increasingly difficult to walk the three blocks without stopping to rest at frequent intervals. At work, his manager has also expressed concern about the effect Mr. L.'s continuous coughing has on customers. According to the National Heart Lung and Blood Institute, "COPD is the 3rd leading cause of death in the United States. The disease kills more than 120,000 Americans each year-that's 1 death every 4 minutes-and causes serious, long-term disability. The number of people with COPD is increasing." This is why it's important for people to know the signs, symptoms, prognosis and treatments for COPD.